Fillable CSUDH Course Modification Form Checklist below are required (California State University, Dominguez Hills)

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CSUDH Course Modification Form Checklist below are required (California State University, Dominguez Hills)

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The CSUDH Course Modification Form Checklist below are required (California State University, Dominguez Hills) form is 7 pages long and contains:

  • 6 signatures
  • 57 check-boxes
  • 80 other fields

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CSUDH
CALIFORNIA
STATE
UNIVERSITY
,
DOMINGUEZ
HILLS
I
1000
EAST
VICTORIA
STREET
I
CARSON
,
CALIFORNIA
90747
ACADEMIC AFFAIRS
Office of Academic Programs
Course Modification Form Checklist
The sections listed
below are required on the Course Modification form. Please review the the proposal and check off each
section to indicate that the section has been completed and include the completed check
list as the cover page for the proposal.
If you have any qu
estions regarding this checklist and/or form, please contact the Office of Academic Programs.
Proposed effective term
Current course information
Select appropriate changes and complete/attach ALL required information
Justification for modification
Special designations (GE, Writing Intensive, Service Learning)
Evidence of consultation with affected departments/programs
Campus-wide sharing (Curriculum Register) synopsis
CSUDH
CALIFORNIA
STATE UNIVERSITY,
DOMINGUEZ
HILLS
I I
I I
Office of Academic Programs • WH 440 • creview@csudh.edu
REQUEST FOR COURSE MODIFICATION
Date: College: Dept.: Extension:
Proposer Name: Email:
Proposed Effective Term:
1. Current Course Information
Course Title:
Course Description:
Course Subject: Course Number: Units: ______ Min. ______ Max.
Prerequisites: List all required and recommended prerequisites.
Co-requisites: List all required and recommended prerequisites.
AP (Rev. 10/2019)
CSUDH
CALIFORNIA
STATE UNIVERSITY,
DOMINGUEZ
HILLS
Office of Academic Programs • WH 440 • creview@csudh.edu
2. Proposed Modifications: Check ALL changes that apply and complete/attach the relevant information.
Inactivate (Freeze) Course: The course will remain active in the catalog and People Soft, however, will not be
currently offered, will be listed as infrequently offered, and can be reactivated
upon request.
i. Attach rationale for course inactivation.
ii. Will course be replaced by another course? Yes No
If yes, list courses below:
Course
Subject
Course
Number
Course Title
iii. Does this change affect another program/department? Yes No
If yes, attach evidence of consultation with affected programs/departments.
iv. For undergraduate courses, is the course currently articulated with a community college(s), other CSU,
or other University? Yes No
Discontinue (Retire) Course: This change will remove the course from the catalog and inactive it in People Soft.
i. Attach rationale for course discontinuation.
ii. Will course be replaced by another course? Yes No
If yes, list course(s) below:
Course Subject
Course Number
iii. Does this change affect another program/department? Yes No
If yes, please provide evidence of consultation with affected programs/departments.
iv. For undergraduate courses, is the course currently articulated with a community college(s), other CSU,
or other University? Yes No
Course Subject: ____________________________________
Course Number: ___________________________________
AP (Rev. 10/2019)
CSUDH
CALIFORNIA
STATE UNIVERSITY,
DOMINGUEZ
HILLS
__________________________________________________________________________________________
Office of Academic Programs • WH 440 • creview@csudh.edu
Course Title:
Unit Value: Complete and attach the unit count template if the change affects the total program units.
Min. ____ Max. ____ i.
Repeatable for credit
i. M
ax number of units: __
__.
ii. M
ax number of completions ____.
iii. Mu
ltiple sections in same term: Y N
Course D
escription
Prerequisite(s): Include required and recommended perquisites.
Co-requisite(s): Include required and recommended co-requisites.
AP (Rev. 10/2019)
CSUDH
CALIFORNIA
STATE UNIVERSITY,
DOMINGUEZ
HILLS
Office of Academic Programs • WH 440 • creview@csudh.edu
Course Utilization: List academic programs where course will be utilized.
Grading Method (Check all that apply)
A-F and CR/NC by petition
CR/NC
A-C/NC (available for undergraduate courses only)
A-C-/NC (available for undergraduate GE Basic Skills courses only)
A-B/NC (available for graduate courses only)
RP (available for graduate courses only)
Method of Delivery (Check all that apply)
Face-to-face
Online
Hybrid % online _________ %face-to-face _________
Television
Off Campus
- Include preliminary list of all requested location/facilitie
s
Mode of Instruction (Check all that apply and identify CS# and # of units.)
Lecture C/S# ______ # of units _____
Seminar C/S# ______ # of units _____
Laboratory C/S# ______ # of units _____
Activity C/S# ______ # of units _____
Production C/S# ______ # of units _____
Supervision C/S# ______ # of units _____
Enrollment Restrictions (e.g., seniors only, restricted to majors only, etc.)
AP (Rev. 10/2019)
CSUDH
CALIFORNIA
STATE UNIVERSITY,
DOMINGUEZ
HILLS
Office of Academic Programs • WH 440 • creview@csudh.edu
3. Complete and atta
ch the following
i. Attach rationale for the proposed modification(s) addressing the following:
a. identify the course as it is currently built (i.e., grading method, mode of instruction, enrollment
restrictions, modality, etc.) and explain the need for the curse changes;
b. the need for the course, including whether being proposed in response to academic program review or
accreditation recommendations and any other relevant data and/or documentation
c. the level of course and prerequisites, including having NO prerequisites for a 300, 400, or 500 level
course
d. CR/NC only grading
ii. If proposing change to course description or prerequisite or co-requisite, complete and attach the SLO to PLO
matrix demonstrating how the assignments align to the SLOs and how the SLOs align to the Program Learning
Outcomes.
iii. If proposing an existing course for GE:
a. Identify Area _______
b. Complete GE Program Learning Outcome Matrix and attach
iv. If proposing an existing course to have a special designation:
a. Select special designation
Writing Intensive
Service Learning
b. Include rationale for special designation.
Yes
No
v. Does this proposal affect another department(s)
If yes:
a. List affected department(s)
b. Attach
evidence of consultation with the affected departments.
vi. Curriculum Register Synopsis: Include summary of changes to be posted for campus-wide sharing.
AP (Rev. 10/2019)
CSUDH
CALIFORNIA
STATE UNIVERSITY,
DOMINGUEZ
HILLS
Office of Academic Programs • WH 440 • creview@csudh.edu
1.
Faculty Proposer (Print)
Signature
Date
2.
Department Chair/Program Coordinator (Print)
List names of department faculty who approved this
proposal. (Note: The number of names listed must constitute
a simple majority of voting faculty members in the
department.)
Signature
Date
3.
Dept. Curriculum Com. Chair/ Faculty Designee (Print)
Signature
Date
4.
College Curriculum Committee Chair (Print)
Signature
Date
5.
University Curriculum Committee Chair (Print)
Signature
Date
6.
VPAA/Designee (Print)
Signature
Date
AP (Rev. 10/2019)
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CSUDH Course Modification Form Checklist below are required (California State University, Dominguez Hills)

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Completed 18 August 2020

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